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May 2010 Archives

By Laura Nathan-Garner, Staff Writer

Planning to spend some time outdoors this weekend? A new report might have you second-guessing whether you should bother applying sunscreen. Earlier this week, the Environmental Working Group (EWG) suggested that only 8% of sunscreens provide adequate protection -- and that some sunscreens might even speed up the growth of tumors.

Rest assured. We here at MD Anderson still think it's a smart move to use sunscreen.
There's no scientific proof that sunscreen causes cancer. Susan Chon, M.D., assistant professor in MD Anderson Department of Dermatology, says the most likely explanation for some sunscreen users getting skin cancer is that they aren't applying sunscreen often enough or are over-relying on a high SPF.

In fact, most sunscreens didn't make the EWG's cut because they gave users a false sense of security with high SPF numbers. For example, if you use a sunscreen with SPF 60, you might think you can safely stay in the sun twice as long as if you used SPF 30. But you can't.

The protection an SPF offers doesn't increase proportionately with the designated SPF number. SPF 15 absorbs 93% of the sun's burning rays, while SPF 30 absorbs 97%. Increases after that are even smaller.

So instead of worrying about using the sunscreen with the highest SPF, focus instead on how -- and how often -- you apply sunscreen. Get the 411 on how to make sunscreen work for you in this short video.

Also remember that you can't rely on sunscreen alone to protect your skin from cancer.
For more insight on sun-safety and the EWG's report, check out our recent TweetChat with Dr. Chon

How do you plan to protect your skin from the sun this summer?

By Lana Maciel, Staff Writer

KWooAML.jpgIn May 2003, Kenneth Woo was enjoying eight years of living cancer-free, having overcome his second bout with Hodgkin's disease in May 1995. But after that eight-year stretch, he began experiencing more health problems. Simple daily activities were taking a toll on his body.

His heart would race after a routine trip up the stairs in his two-story Sugar Land, Texas, home. Even a day spent with friends on the golf course was tiresome. He felt dizzy every time he bent down to pick up the golf ball.

Considering he had gone so long without a cancer relapse, Woo knew his chance of recurrence was slim, so his first thought was that maybe he was anemic. But a subsequent visit to the doctor indicated a diagnosis that was much worse. What he had was acute myelogenous leukemia (AML), an aggressive form of leukemia with a low survival rate.

"The doctor told me that AML was a typical side effect of the type of radiation and chemotherapy treatments I received from Hodgkin's disease," Woo says. "Because two of my chromosomes were mutated from previous cancer treatments, it didn't look promising."

Facing a new challenge
The diagnosis left Woo speechless and shocked. The fact that he had leukemia was a difficult reality to face. And the fact that the survival rate was less than 20% was an even bigger blow.

As Stefan Faderl, M.D., associate professor in MD Anderson's Department of Leukemia, explained to Woo's wife, Clara, although the disease wouldn't kill him, the chemotherapy might, particularly because of the highly toxic level of treatment required.

Woo was enrolled in a clinical trial developed from a pediatric leukemia treatment, and he immediately began chemotherapy.

Not only did he lose 40 pounds, but he couldn't see his two young daughters for weeks because he was in isolation. And when his blood cell count dropped to zero, he could only see his wife through a glass window.

Armed with his strong Christian faith and the support of family and friends, Woo found the strength and motivation to fight through the cancer.

Finding a match
Though Woo's AML treatment went well, Marcos de Lima, M.D., associate professor in MD Anderson's Department of Stem Cell Transplantation and Cellular Therapy, told him that it wasn't all over just yet. Chemotherapy alone would not cure him. His best option for a long-term cure would be to receive a stem cell transplant.

With his family in town visiting from Hong Kong, doctors began typing for a suitable donor. Woo's oldest sister, Emily, turned out to be a perfect match.

As part of another clinical trial, Woo received the drugs fludarabine and intravenous busulfan, a combination invented by Borje Andersson, M.D., Ph.D., professor in MD Anderson's Department of Stem Cell Transplantation and Cellular Therapy. The combination made Woo's immune system less likely to reject the transplant and more receptive to the new stem cells.

The procedure was complete on Oct. 3, 2003. After five difficult months, Woo had won the battle against AML.

"It's been seven years since the transplant, and since then I've been doing well," Woo says. "There are still some minor side effects, but they're manageable."

Life after AML
Woo continues to take anti-rejection drugs to keep his immune system from fighting the transplanted stem cells. It's a small inconvenience, and it's one that he's happy to do considering it keeps his body healthy and free from the AML that threatened to take his life.

As a result of his experience, Woo is a firm believer in donating stem cells every chance he gets, as is his wife. He also continues to give back to MD Anderson, volunteering at the hospital and working with the Anderson Network, a patient-to-patient support organization that is part of the Department of Volunteer Services, as a mentor and supporter for other patients.

"Without having gone through that experience, I couldn't do what I do now," Woo says. "Friends and patients going through treatments can identify with me, and it helps them to know that I understand, that I've been there.

"It's one thing for a doctor to explain something to a patient. But as a patient myself, I can relate to them on a different level and explain to them what it's going to be like. Of course, everyone's experience is unique, but what's important is that I give patients hope."

Related Stories: Q&A: Intravenous Busulfan Before Stem Cell Transplant

MD Anderson resources:

AML

Leukemia Care Center

Stem Cell Transplantation and Cellular Therapy Center

Borje Andersson, M.D., Ph.D.


Additional resources:
Busulfan


The invention of IV Busulfex™ (the intravenous formulation of busulfan) has contributed to a dramatic change in the standard of care for patients undergoing stem cell transplantation for leukemia. It also has greatly improved the outlook for patients with hematologic (blood) and lymphoid cancers.

In March, the lead inventor, Borje S. Andersson, M.D., Ph.D., professor in MD Anderson's Department of Stem Cell Transplantation and Cellular Therapy, was honored with the 2010 Chancellor's Entrepreneurship and Innovation Award from The University of Texas System. He answers questions about this pre-transplant treatment development that has now received regulatory approval for use in 45 countries, with the drug available on a limited basis in an additional three countries.

What is IV busulfan?
IV busulfan is a chemotherapy agent, given to patients intravenously in combination with other drugs, commonly cyclophosphamide, or Fludara™ (fludarabine) or Clolar™ (clofarabine) before they have a stem cell transplant. In 1999, the U.S. Food and Drug Administrations approved IV busulfan for use in chronic myelogenous leukemia (CML) patients undergoing stem cell transplantation.

Why is it combined with other drugs?
Busulfan is one of our most potent anti-leukemia drugs. It's also very toxic to the normal bone marrow cells, but it's not very immunosuppressive. Therefore, it was originally combined with the immunosuppressive drug cyclophosphamide to get the new stem cells to engraft. Because this combination has serious side effects, the cyclophosphamide was later replaced with fludarabine, which is strongly immunosuppressive.

The fludarabine-busulfan combination has proven most effective, especially when used in patients with early leukemia (patients in remission). Using IV busulfan in this combination has dramatically increased the safety of the transplant procedure. The risk of dying from complications during the first 100 days after transplant has come down from about 30%-40% to about 3%, and the chance of being alive and doing well at three to five years after transplant has gone up from about 40% to about 75%, if done in first or second remission of acute leukemia.

For patients with active acute myelogenous leukemia (AML) -- especially when unresponsive to regular chemotherapy -- we're now investigating if a combination of fludarabine and its cousin clofarabine is more effective when given together with IV busulfan than when fludarabine alone is used with busulfan. The early data favor the gradual replacement of fludarabine with clofarabine or, even better, using both fludarabine and clofarabine together with busulfan in this setting.

Why is busulfan so effective before stem cell transplants?
Patients with AML and CML often have high white blood cell counts, and these leukemic cells suppress the production of normal blood cells. Busulfan acts directly on the DNA and indiscriminantly kills both normal and abnormal blood cells -- lowering the patient's white blood cell count -- while having very limited toxicity to organs other than the bone marrow. This makes it ideal for use before a stem cell transplant.

If you have too many abnormal white blood cells, the body has a higher risk of rejecting the transplant. The IV busulfan lowers the number of white blood cells, and with the added immunosuppression of fludarabine, rapidly enables the graft to start growing in the recipient.

For which types of cancer is it most effective?
At MD Anderson, IV busulfan combined with fludarabine is now the standard pre-transplant therapy for patients with AML and myelodysplasia syndrome (MDS), as well as for CML. It's also used for patients with myeloproliferative disorders and myelobfibrosis, and for certain lymphomas and Hodgkin's disease.

Can it be used for children as well as adults?
IV busulfan is gradually replacing total body radiation as pre-transplant "conditioning" treatment for both pediatric and adult patients. This is especially important in children because total body radiation affects physical and mental development.

While physical retardation can be partly addressed with growth hormones, cognitive dysfunction can be as much as 20 points lower than for healthy peers when compared in IQ testing.  Further, total body irradiation is fraught with a significant risk for late development of secondary cancers, such as breast cancer, which is most important when pediatric patients are cured of their initial leukemia.

What comes next?
We've gone back to the laboratory to gain a better understanding of the molecular mechanisms that are at work here. While patients' cancers go into remission initially, many relapse, sometimes as early as within the first few months. We want to know why so we can further increase the effectiveness of our pre-transplant therapy and use these mechanisms to fight the cancer rather than just observe how the cancer gets back in the driver's seat.

MD Anderson resources:

AML

Leukemia Care Center

Stem Cell Transplantation and Cellular Therapy Center


Additional resources:
Busulfan



By: Lana Maciel, Staff writer

For years, doctors and researchers have spent time and energy working toward the common goal of treating and preventing cancer. Thanks to their efforts, cancer survivorship is on the rise, with more than 11.1 million survivors in the United States today.

Five-year survival rates among adults are also increasing. According to the U.S. Centers for Disease Control and Prevention and the National Cancer Institute, 66.4% of adults diagnosed with cancer can expect to be alive in five years, compared to 64% in 2008. Children have an even higher survival rate, ranging between 70% and 92%.

To recognize these growing numbers, a celebration of life will be observed in hundreds of communities worldwide on National Cancer Survivors Day, June 6. At MD Anderson, the entire week of June 7-10 will be dedicated to this celebration.

As more and more patients win the battle against cancer, the emerging field of survivorship has become a welcome challenge that aims at finding ways to help patients regain a sense of well-being after treatment.

Life after cancer

Survivorship is a stage in the continuum of cancer care. Its focus is to prepare patients for the adjustments that come with life after cancer treatment.

Such adjustments include the physical, emotional, social, spiritual and financial effects of the cancer experience. This transitional stage will differ for every patient. Many go into long-term remission, while others may live with a chronic disease that requires periodic treatments.

Many survivors report that they have happily returned to living a normal life, and the physical impact of cancer is minimal. For others, side effects may still be present. Fatigue, osteoporosis, increased risk for other cancers, anxiety, emotional trauma and changes in sexuality are some of the most common side effects experienced by patients.

Of course, survivors will always live with the possibility of recurrence. Some cancer treatments may also cause other health problems that require continuing surveillance and regular visits to the doctor. But no matter what each person may experience, the care and support of family, friends and physicians will be important.

Developing a plan for survivorship

To address the needs and concerns of cancer survivors, MD Anderson has expanded its survivorship program to seven clinics, which include:


More clinics focusing on other cancer types are being opened, including a Colorectal Survivorship Clinic and a Lymphoma Survivorship Clinic scheduled for later this year.

At each of these clinics, survivors may have their annual check-ups, or they may learn more about how to cope with any effects that continue in the years after treatment. Specialized health care providers monitor patients' conditions and help them develop a plan for ongoing health care. This includes the kinds of screenings or medical tests they will need, as well as frequency of follow-up visits for future care. Opportunities for counseling, support groups and further education on post-treatment-related topics are also available in these clinics.

Though each clinic focuses on a specific cancer type or treatment, they are all designed to:

  • Review a patient's medical history and perform a physical examination
  • Monitor for signs of cancer recurrence or progression
  • Identify, prevent and control any late side effects or symptoms from treatment
  • Develop a treatment summary and specific follow-up care plan
  • Provide educational materials related to:
    • Cancer screening examinations
    • Health behaviors that reduce cancer risk
    • Survivorship resources at MD Anderson or within the community
  • Provide a Passport Plan for Health for survivors returning to community physicians

Communication is key
A patient's journey beyond cancer is one of continued education and communication. Health care teams are available to address any questions or concerns a patient may have about the survivorship phase.

The key for maintaining a sense of well-being and a positive quality of life is to keep the lines of communication open between survivor and provider. The more one learns about what to expect after treatment has ended, the better prepared he or she will be in handling what lies ahead in the journey after cancer.

To learn more about cancer survivorship, visit the following websites:

MD Anderson Cancer Survivorship

AARP Journey of Cancer Survivorship

U.S. News: Surviving and Living with Cancer

The recognition and treatment of pain is an important part of cancer management. Yet pain is a more complex entity than we might think.

The neurological and chemical signals that damaged tissues send to the nervous system are basically the same in everyone. However, the interpretation of what those signals mean is quite variable.

When pain strikes, it is accompanied by activity in every part of the body, including multiple areas of the brain. In addition, it is usually associated with some sort of unpleasant emotion. We all experience pain differently, in quality and in severity.

Harry Gibbs, M.D., associate professor and MD Anderson's chief diversity officer, shares recent research on this subject.

By Harry Gibbs, M.D.

Pain is cultural
There is some evidence to support biological differences in the sensation of pain among certain ethnic groups. However, the bulk of our reaction is learned behavior that is partially shaped by our culture.

A study conducted in Ontario demonstrated a difference in pain sensitivity between Canadian-born Chinese individuals and Chinese immigrants to Canada. These differences were attributed to a greater familiarity with Western medical procedures among those born in North America.

Other studies have found that African-Americans with prostate cancer report more severe pain when compared with white men. "Non-traditional" forms of pain management, such as acupuncture, have been shown to be more effective in patients from Eastern cultures than from Western ones.

Pain is judgmental
To deliver appropriate symptom relief, health care providers must frequently determine the presence and severity of pain in patients. Like all other assessments, this judgment is affected by experiences and cultural biases.

Historically, providers frequently diminished pain severity in ethnic minority patients and prescribed inadequate doses of analgesics. Reasons for this ranged from a sense that the patient was "hysterical" or was faking the pain, to a fear of creating or enabling a "drug addict" by giving narcotics.

Language barriers have also been sited as possible cause for misinterpretation, although a recent study showed little difference in the effectiveness of pain assessment tools when they were properly translated for patients who did not speak English.

Pain is manageable
Pain control cannot be measured by instruments. It is determined almost exclusively by asking patients how they feel. Therefore, cultural and linguistic approaches to pain management need to be developed so that patients can fully describe their pain and the impact of therapies.

In addition, a more holistic approach to pain, which includes not only the biological but also the personal, cultural and psychological determinants of pain sensation, will result in more effective diagnosis and management.

MD Anderson resources:

Office of Institutional Diversity

Getting to know Harry Gibbs, M.D.

Pain Management Center

Patient Education: Pain Management

Cancer Pain (audio webcast with Allen Burton, M.D.)
     
 

Lee_PTC.jpgNo man wants to hear the sentence, "You have prostate cancer," but more than 190,000 men in the United States will be told that this year.

Prostate cancer is the second-leading cause of cancer deaths in this country, but the good news is that the death rate is decreasing. In fact, when prostate cancer is detected early and treated properly, men have a five-year survival rate of nearly 99%. But choosing the right therapy remains a daunting task for men facing this disease and their families.

Trying to learn about the diagnosis and the treatment options can be difficult. Choosing between external beam radiation therapy (proton therapy and IMRT), surgery (open vs. robotic-assisted) and brachytherapy (radioactive seed implant) can create anxiety for even the most informed patient.  

One size does not fit all
As a prostate cancer specialist, I would say that there is no one perfect therapy for every single patient, but I do try to give each patient all the information he needs to make the right decision for his case. While I want to effectively treat my patient's cancer, I also want to preserve his quality of life - during and after treatment - as much as possible.  

All definitive treatments for prostate cancer carry the chance of side effects, which vary depending on the actual therapy and the patient. But we are always striving to minimize these effects by selecting the appropriate treatment for each patient.  

External beam radiation therapy is one of the most effective and flexible treatments for a wide range of prostate cancers. It can effectively treat localized disease, as well as more locally-advanced tumors, with good results.

Proton therapy a good option
Technologic advances also have improved our ability to deliver higher radiation doses to the prostate, while decreasing the risk of normal tissue damage. Proton therapy is one example of how advanced technology can be used to help treat patients, since the unique physical properties of protons allow higher radiation doses to be deposited at the tumor while minimizing unnecessary exposure to surrounding normal organs. This may result in improved cure rates with fewer side effects and can be done using just a few beams (one right-sided and one left-sided beam), which is something that cannot be done with even the most advanced X-ray techniques.

MD Anderson is fortunate to be one of a few centers in the world with proton therapy available for our patients.

Proton treatments typically take only 15 to 20 minutes each day and are delivered five days a week for approximately seven to eight weeks. Most patients tolerate the treatments extremely well and are able to continue to work and exercise during their treatment course and immediately after treatment is complete.

Proton therapy is one of the most flexible treatment options available for prostate cancer. At MD Anderson Proton Therapy Center, we've treated a wide range of tumor stages of prostate cancer as well as a variety of patients with proton therapy. So, it may indeed be an excellent option for many men, depending on their unique situation.
 
No matter what you decide to do, begin by talking with your oncologist. And don't be afraid to ask and get in-depth details about all of your options.



Resources


The Proton Therapy Center at MD Anderson Cancer Center www.mdanderson.org/proton

ProtonPals, a support group for patients at the MD Anderson Proton Therapy Center
www.protonpals.net

Evaluating its change over time, CA-125, the protein long recognized for predicting ovarian cancer recurrence, now shows promise as a screening tool for early-stage disease, according to recent study results presented by Karen Lu, M.D., professor in MD Anderson's Department of Gynecologic Oncology.

During this study 3,252 women were enrolled from seven sites across the country, with MD Anderson serving as the lead site. All were healthy, post-menopausal women, ages 50-74, with no strong family history of breast or ovarian cancer. The study's primary endpoint was specificity, or few false positives. In addition, the study looked at the positive predictive value, or the number of operations required to detect a case of ovarian cancer.

Each woman received a baseline CA-125 blood test. Using the Risk of Ovarian Cancer Algorithm (ROCA), a mathematical model based on the patient's age and CA-125 score, women were stratified to one of three risk groups, with the respective follow-up: "low," came back in a year for a follow-up blood test; "intermediate," further monitoring with repeat CA125 blood test in three months; and "high," referred to receive transvaginal sonography (TVS) and to see a gynecologic oncologist.

Based on the women's CA-125 change over time, the average annual rate of referral to the intermediate and high groups were 6.8% and .9%, respectively. Cumulatively, 85 women (2.6%) were determined to be high risk and thereby received the TVS and were referred to a gynecologic oncologist. Of those women, eight underwent surgery: five were found to have ovarian cancer, three with invasive and two with borderline disease; and three had benign tumors - a positive predictive value of 37.5%. Consequently, no more than three operations would be required to detect each case of ovarian cancer, Lu expalins. The screening failed to detect two borderline ovarian cancers.

Each year, about 22,000 women in the United States are diagnosed with ovarian cancer. 

The symptoms of ovarian cancer are often common and vague, which makes it difficult to diagnose. Currently, there is no effective early detection method for ovarian cancer. It is usually diagnosed in advanced stages, and only about half of women survive longer than five years after diagnosis. For the 25% of ovarian cancers that are found early, the five-year survival rate is greater than 90%.

Mir&Lane.jpgLynn Lane is a young prostate cancer survivor who founded a website,  VoicesofSurvivors.org, where video and written stories give a voice to cancer survivors from all over the world.

Marisa Mir is a program coordinator for MD Anderson's Anderson Network, and organizer for Cancer180, a program developed to provide support to survivors ages 18-39. She was diagnosed with colon cancer while in her 20s.

In a recent Cancer Newsline episode, they came together and talked with host Lisa Garvin about how their cancer journeys inspired online and offline outreach efforts to other young survivors.

Striking Out Cancer

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Gail_strikethruWhat does it mean to change the way you look?

This is not simply a case of losing weight or adding highlights to your hair. This is putting it out there for all the world to see. This is making a bold statement about who you are, what you stand for and what you plan to do about it.

This is the new logo launched just a week ago by The University of Texas MD Anderson Cancer Center. And, did you see the way I wrote MD Anderson? That's part of the new editorial standards that go along with the new look.

What now appears is a brand that lets everyone know that MD Anderson fully intends to eliminate cancer from our lives. With a bold swash of a red pen, we are striking out cancer. That's what we're all about - mounting the forces of research, treatment, technology and care to just get rid of this disease.

There are some who say that cancer will not ever be eliminated, but will become a condition that one learns to live with - something like what has happened to diabetes, which is still a bad thing to have, still something that can eventually kill you if you don't take care of yourself, but still something you can live with.

In fact, many people are already doing that today with cancer - they live with it. Of course, some people do not survive the scourge, but many others do. They continue with medication, regular checks and treatments, but they are still here. Some choose to improve their diets by eating organic or foods filled with cancer-fighting antioxidants. Some add exercise and movement to their daily routines. Others are convinced that their positive attitudes have much to do with their continued good health. But, at the end of the day, they do still have cancer.

With the red strike-out of the word "Cancer," MD Anderson is saying to all who will listen that making this disease go away is what this institution is all about. With the sweep of a red pen, it is gone, out of our lives forever.

Isn't that an amazing goal? I believe this is an exemplary thing to strive for. And, since I'm a cancer patient myself, I'm glad that MD Anderson has let us all in on the plans for the future.

MD Anderson is Making Cancer History®. I'm delighted to be a part of that effort.

By Laura Nathan-Garner, Staff Writer
Summer Skin UmbrellaWith more than one million new cases diagnosed each year, skin cancer accounts for almost half of the cancers in the United States, says the American Cancer Society. Luckily, it's also one of the most preventable and -- if spotted early -- curable cancers. 

This summer, protect your skin by taking extra sun-safety precautions and getting to know the blemishes, birthmarks and moles on your body.

Learn about a chic way to protect your skin, get summer sun-safety tips for the whole family, and find out about skin cancers that develop in places "where the sun don't shine" in the May issue of Focused on Health, MD Anderson's online healthy living newsletter.


Featured articles include:

Stylish Shade on Summer Days
Open a parasol on a blazing hot summer day. It's a fashionable and functional way to prevent skin cancer. Learn what type of parasol works best on summer days.

Go on Spot Patrol
Who'd a thought? That tiny spot in-between your toes could be skin cancer. That's right! Skin cancer can occur anywhere on your body. Get familiar with areas normally hidden from view.  

5 Tips for Kid Sun Protection
Temperatures are heating up. Your kids are sweating; they're swimming. They need extra sun protection! Get extra sun-safety ideas beyond just sunscreen.

Do Your Skin a Favor: Skip the Tanning Bed
Tanners, beware! Tanning beds increase skin cancer risk by a whopping 75% for users under 30. Learn more alarming tanning facts, and share advice on self-tanning products.

Videos and Podcasts

ABCDEs of Melanoma (1:24)

Know the Skin You're In (3:04)

The 411 on Sunscreen (4:05)


By Will Fitzgerald, Staff Writer

It's one of the most dangerous forms of cancer. It often develops with little warning and poses a similar threat to a 20-year-old as it does to an 80-year-old.

The culprit in this cancerous riddle is melanoma, a disease that claimed 68,720 lives in 2009, according to the American Cancer Society.

Walk, fun run May 15
To raise awareness and funds, MD Anderson is taking the message to the streets, hosting the third annual AIM for a Cure Melanoma Walk and Fun Run on Saturday, May 15, at 8 a.m. Runners and walkers will wind their way through the Texas Medical Center with other supporters, survivors and family members.

To provide participants with an up-close and personal view of the disease, Jason Connelly, a stage IV melanoma survivor, will share his courageous journey and the importance of prevention.

"Ironically, a lot of cancer survivors say their diagnosis was the best thing that happened to them," Connelly says. "It brought me closer to my son and wife and also put me on a quest to give back."

The first step in his diagnosis was a visit to a dermatologist, who discovered and removed a mole with melanoma. Years later, after suddenly feeling sick, Connelly underwent exploratory surgery at MD Anderson. The news was grim; the mole from years earlier had developed into stage IV melanoma, a serious disease with a 10% survival rate.

JasonC.jpg"The first time I heard that I had melanoma removed, I didn't know what to think," he says. "The second time I went back in, I was scared."

Taking a positive approach
Still, the will and determination to overcome his disease was enormous. Connelly made a conscious decision to one day see his young son's wedding and knew that hope would carry him through.

"I think cancer treatment is a lot harder emotionally than physically," he says. "The doctors can manage your pain, but the most important thing is to keep your mind in the right place."

And that's exactly what he did. Now, Connelly is a healthy dad and proud husband. He has a new outlook on life and is dedicated to raising melanoma awareness.

It shouldn't come as a surprise that Connelly is the guest of honor at Saturday's event, where he's looking forward to participating with his wife and son.

To register for the run, visit www.aimatmelanoma.org.

Intro by: Mary Brolley, Staff Writer

Adelea Ibsen was just 30 when diagnosed with late-stage breast cancer. At the time of diagnosis, she was living in East Germany with her husband and two young daughters. Because of her illness, the family immediately moved back to Texas so she could be treated at MD Anderson.

Ibsen now commutes from her Austin home weekly to participate in a Phase I clinical trial under the direction of Richard Theriault, DO, professor in the Department of Breast Medical Oncology.

Today's post begins an occasional series on her experiences with cancer and treatment.



adelea_couch_edit.jpgPost by: Adelea Ibsen

Tuesdays are my sleep days. My nap-on-the-couch -- until the very last moment I have to go get the kids -- days.  The days the laundry is not done, dinner may be cottage cheese, crackers, tomatoes and bananas (for the kids) and I may or may not shower.

See, I have slowly started to give myself breaks as "The Great Cancer Experience" unfolds. Things such as allowing myself to eat crappy food on Mondays (chemo days) -- Hooters, Doritos and ice cream.  On Tuesdays, the days after chemo, I just lie down and nap for as long as I want to.  As opposed to how ever long I am allowed by my 2- and 4-year-olds, who see naps as accusations versus privileges.  

They may seem off, my self-indulgences. But for me, the queen of self-discipline, semi-organization and consistency, they feel a little care-free and dangerous.  

Most people had to tighten up their sails when they discovered they had cancer.

Eat better, stop smoking, exercise, attempt positive outlooks on life, etc.

I was the opposite. I was wrapped a little too tight. I needed to slow down, give myself a break, live a little bit on the edge.

And yes, eat Cheetos, take naps when I can and not keep my house spotless. These things were always accompanied by guilt for what I should be doing and the example I was setting and what others might be thinking, blah blah blah.

They still feel a little bit like cheating -- but now, who cares?

They feed my soul and give me a much-needed rest.


A clinical trial network funded by the National Cancer Institute has contributed to major advances in cancer treatment over the last 50 years, but needs an overhaul to keep pace in the 21st century.

That's the verdict of an extensive evaluation of the NCI's Clinical Trials Cooperative Group Program. The 10 cooperative groups comprise more than 3,000 institutions and 14,000 investigators who enroll 25,000 people in cancer clinical trials annually.

"Cooperative groups fulfill an important role by conducting large-scale clinical trials of topics that aren't priorities for industry," says MD Anderson President John Mendelsohn, M.D., who led the review. "The problem is that the cooperative groups have become very inefficient, which is frustrating for everybody."

Cooperative group trials, for example, compare the effectiveness of existing drugs, test combination therapies and address rare cancers that otherwise might be ignored.  

Mendelsohn chairs study committee

The NCI requested the review by the Institute of Medicine of the National Academy of Sciences. Mendelsohn, an IOM member, chaired the study committee, which released its report in April. Since then, Mendelsohn has presented the recommendations to the American Association for Cancer Research annual meeting and The New York Times editorial page endorsed the report.

Donald Berry, Ph.D., professor and head of MD Anderson's Division of Quantitative Sciences, also served on the committee.

The IOM report lists 58 cooperative group clinical trial contributions to major advances in cancer treatment, including an increase in the cure rate for pediatric leukemia patients from 10% to 80% and the shift to less disfiguring surgery for breast cancer.

The multi-institutional nature of the groups leads to a complex network of reviews and approvals that cause delays, according to the report.

The median time from approval of concept to the launching of a Phase III clinical trial is two years, with a range of 1.25 to 7 years. Trials that launch late often have trouble recruiting participants and sometimes never finish. Only 60% of NCI-funded Phase III clinical trials are completed.

In one case, starting a clinical trial involved more than 800 process steps and 68 review loops -- instances where a change in the protocol, even a minor one, made by one review committee required the plan to be returned to previous reviewers.



Report recommendations
Among the report's recommendations are to:

•    Consolidate administrative and support functions, currently redundant in all 10 cooperative groups, based on a rigorous comparison of relative performance.

•    Eliminate clinical trial sites that enroll few patients or provide inadequate data.

•    Terminate trials that don't open within a set time -- two years for Phase III trials, for example.

•    Shift NCI's role from an emphasis on oversight to one of facilitation and support for high-quality clinical trials.

•    Increase reimbursement of clinicians for managing each patient in a trial and pay for their work designing and planning clinical trials. NCI reimbursement per case has been frozen since 1999 at $2,000, while actual costs run $4,500 to $6,000 per patient.

•    Give greater weight to cooperative group participation for clinicians in tenure and promotion decisions at academic institutions.

•    Push private and public health plans to cover the cost of non-experimental treatment in clinical trials. Many don't now, discouraging patients from enrolling.

•    Increase NCI funding by allocating a greater percentage of its budget to the cooperative group program to raise reimbursement to $4,000 to $6,000 per case. At $145 million a year, the program accounts for 3% of the NCI budget.

This is particularly important because clinical trials are becoming more complex as they focus on therapies tailored to the molecular aspects of a patient's tumor and the discovery of tumor biomarkers to guide treatment. Group trials need to make optimal use of scientific innovation.

"If adequate funding is not available, then the total number of cooperative trials should be reduced," Mendelsohn says. "This was our hardest recommendation to write. It's strong medicine, but we will have no other choice if we are to fully support high-quality clinical trials."

A print version of "A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program" can be ordered at the IOM website; an online version may be viewed free of charge.

By: Will Fitzgerald, Staff Writer

satcher_lecture.jpgImagine blasting off the face of Earth in a NASA shuttle and arriving in outer space 8½ minutes later. It's a breathtaking journey by anyone's account and so rare, in fact, that only one in every 650 million people will experience it.

Luckily, those odds didn't work against Robert Satcher, M.D., Ph.D., assistant professor in MD Anderson's Department of Orthopedic Oncology, as he was chosen to spend 11 days in space aboard the Space Shuttle Atlantis.

His journey was the subject of a recent presentation at MD Anderson. I was fortunate enough to attend and learn about his wild ride.

"During our mission we completed 171 orbits around Earth, or 4.5 million miles," he said. "It gives you an appreciation for our home planet."


Staying in shape
Satcher's mission took him to the International Space Station to resupply, perform maintenance and conduct tests on how the human body reacts in space. He was particularly interested in studying skeletal muscles and bone density, due to the affect of zero gravity, which increases atrophy. For this reason, while in space, astronauts must exercise their muscles at least once a day to maintain their strength. Interestingly, he joked, some astronauts come back stronger because they have been working out so frequently.

"We have learned a lot about what it takes to survive in space," Satcher said. "We learned how to start IVs and to make sure that when you push the needle in, you're not also pushing yourself away."

Even everyday tasks such as personal hygiene were complicated, especially when you had a room full of guys, he said. This included using waterless shampoo and strapping oneself to the toilet, not easy or comfortable adjustments.

The real challenge, and one of additional research, was on circadian rhythms -- the biological clock that influences sleep patterns. "It took me three days just to get used to sleeping because you're just floating around, even if you're still in the bag," he said.

Walking in space
During the mission, Satcher conducted three space walks to check the station's outside equipment, while employing his finely tuned surgical skills to navigate a robotic arm scanning for shuttle damage. He likened the tedious nature of this task to his experience in the operating room.

Still, the fine art of actually getting out of the space suit was an incredibly tricky undertaking. On a video presentation, footage revealed one of Satcher's crew mates standing on the suit to prevent it from slipping, while Satcher wiggled his way out. He called it more difficult than birthing a baby calf.

I, like many others in attendance, was amazed at Satcher's accomplishments. He earned his Ph.D. in chemical engineering from MIT and his M.D. from Harvard Medical School. Now, as one of NASA's finest, he is quite literally "out of this world." Or as MD Anderson President John Mendelsohn, M.D., said, "There are no underachievers here."

M.D. Anderson doc tweeting from space (Houston Chronicle Med Blog)

Things I Know to Be True

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GailandFamily.jpgAsk any of my friends - I really love the microphone. So, when I was offered an opportunity to team up with my brain surgeon and speak on my cancer experience and the progress in treatment and technology for brain tumors, I immediately asked him and we said yes.

When it was almost time for the annual fundraising luncheon for the Volunteer Endowment for Patient Support (VEPS), I used my "waking sleep" thinking about what I might say. I spent even more time obsessing over the pronunciation of "oligodendroglioma," the type of tumor I was diagnosed with. I worked a little on Saturday before the Wednesday event just jotting down some notes for my speech. I read them the next day - boring, truly boring.

Sunday night, again in my waking sleep, I came up with a way to approach the talk - everything I planned to say came under the heading of "Things I Know to Be True." So, for those of you who missed what I had to say, here is what I know:

•  If you can pronounce Ollie - go - den - dro - glioma, you probably have one. I practiced and practiced and I still can't say it.

•  MD Anderson is a small world after all. It was amazing how many friends I saw the first time I walked in the doors of Clark Clinic as a patient.

•  The BrainSUITE looks pretty different when you're awake. A personal tour conducted by my surgeon after the fact made me glad I hadn't seen it before. While a GPS is always nice, it's strange to think that someone is using one to map your brain.

•  Extra-strength Tylenol is the drug of choice. When I asked what to do if my head hurt once I was home from the hospital, this was the advice given me.

•  My family comes in full force! I'm telling you, they were everywhere - during doctor's appointments, waiting through the surgery and for a long time afterwards, they were, and continue to be, a true support group.

•  Everyone needs a support group. I mentioned my family, but I can't forget my friends and colleagues who were there every step of the way. How would you like dinner delivered to your door each day for two months? It really did happen.

•  It's very different to be a patient. I've been an MD Anderson employee for more than 10 years now, but I wasn't expecting to be a patient. You certainly see things from another side when you take off that badge and come here to see a doctor.

•  Oct. 1 - Independence Day! Most people celebrate the Fourth of July. I celebrate Oct. 1 because, after six long months, that was the day that I was allowed to drive again. My husband is a great chauffeur, but it's nice to be able to drive myself around again.

•  Memories. I've lost some, but I've certainly made some new ones. I thought I remembered every bit of those first few days of April - turns out that I don't. However, I sure have some special friends to thank and celebrate for being with me the entire time.

•  Happiness is a warm blanket. This is the final thing I know to be true. After years of serving on the VEPS disbursement committee and funding blanket warmers for various clinics and areas at MD Anderson, I myself was offered a warm blanket. Believe me, there's nothing in the world like it. So, if anyone ever offers you one, take it!

Like my colleagues, I'm an avid reader of medical journals as I try to understand and incorporate all the latest advances in cancer medicine.

In the April Journal of Clinical Oncology, in addition to the usual scientific contributions, I found a poignant essay written by a physician in India called "Life's lesson lost ... and learned." The author focuses on what she learned from a 12-year-old girl who lost her mother to breast cancer.

Ironically, this essay actually reminded me of our Making Cancer History campaign. You may have seen this on television or on our website, with all the inspiring stories of individuals who have been cured of malignant diseases and have their picture shown with a red line drawn through the name of their cancer. 

The essay in the Journal of Clinical Oncology reminded me that one can be part of Making Cancer History in many different ways, and becoming a patient cured of cancer is one fabulous pathway but not the only way. Imagine a person in the campaign with a red line through the phrase "cancer pain" or "hopelessness," or something else that's an eradicable source of suffering that extends beyond the tumor's mere existence.

Let me propose three additional pathways on the road to Making Cancer History: 
 

1.    Making ambitious but appropriate goals in the face of cancer and reaching them.
2.    Giving the gift of the "teachable moment" to share with family, friends and the medical team.
3.    Discovering ways to reach outside of our institutional structure to make something extraordinary happen for patients with cancer or risk of cancer.

Here are some specific illustrations for each additional pathway.


pamandjimMaking ambitious but appropriate goals

Ms. June Stokes is a long-term survivor of stage III ovarian cancer, and we have stayed in close touch over the years.

Her cousin, Jim McArthur, is from Glenmora, La. He was principal of Glenmora High School and his wife, Pam, was a teacher at the high school. 

Unfortunately, Pam became ill shortly after her youngest of three daughters was married. She died on Nov. 20 at the age of 56, about 23 months after being diagnosed and cared for at MD Anderson for a rare form of malignancy. About six months before she died, Pam developed kidney failure requiring dialysis. She recovered at home for about two additional months, and then she set some goals for things that she wanted to achieve toward the end of life. 

1)  She wanted to get strong enough to fly to Canada and visit her youngest daughter and get to see where she lived and meet the in-laws. Accomplished!

2)  She wanted to go to New York City and see a play on Broadway. Accomplished!

3)  And most of all, she wanted to get strong enough to return to MD Anderson and WALK into the department where she had received amazing care for weeks. Accomplished!

Ms. Stokes described this inspiring course, writing to me by e-mail that, "The staff on the floor who had taken care of her were speechless when she came walking in. It was really a miracle. And that was her main wish for when she was discharged from MD Anderson -- everything that could be done had been done. The staff called her 'their angel.'"

The gift of the teachable moment

Another example is Mr. Doan Nong, a 78-year-old man from Houston. Mr. Nong died on Easter Sunday, about one month after I first met him at MD Anderson when he came for an outpatient visit and soon learned that he had advanced liver cancer.

He had significant pain, but he had a remarkable zest for life and he was eager to receive therapy for this malignancy. Unfortunately, the medical circumstances did not allow him to begin the prescribed treatment, but he was able to achieve good pain control and he ultimately died peacefully and surrounded by his loving family at home with the assistance of hospice. 

Mr. Nong and his family, in my mind, contributed to Making Cancer History. He contributed the gift of the teachable moment. The lessons learned were not related to illness or even the biology and treatment of cancer symptoms. The real lesson here is a man's striving for life in the face of difficult circumstances, his incredible loyalty and love for his family, and the downstream legacy of loyalty and love reflected back to him by so many. 

His story of personal courage as a war veteran and prisoner of war is one of many things about him that I did not comprehend until I attended his funeral. As his oncologist, I was privileged to get to know him, his story and his inspiring family to share in Making Cancer History through receipt of the teachable moment.

Reaching outside of our institution to make something extraordinary happen

And my final example relates to some inspiring colleagues at MD Anderson who work in the Division of Cancer Prevention and Population Sciences, Department of Health Disparities.  Beverly Gor, Ed.D., and Lynne Nguyen work in different programs in their department, but they worked together as community volunteers to develop a dream. 

Spending many hours of their time along with their friend, Mrs. Rogene Calvert, they worked through the Asian-American Health Coalition and in 2001 realized their dream of creating a new medical clinic. The Hope Clinic was created to provide affordable care for many vulnerable individuals and families in West Houston. 

hopeclinic_edit.jpgBy 2008, the Hope Clinic received funding as a federally qualified health center, and they have received other significant grants from foundations and the state of Texas to further improve patient care. Among other things, this clinic is unique in having developed funding to screen patients for hepatitis B and help take steps to treat and prevent this condition that puts patients at risk for liver cancer.

See the report from My Fox Houston about the Hope Clinic: www.myfoxhouston.com/dpp/health/100419-hope-clinic-asian-americans

The great thing about MD Anderson is that Making Cancer History is something that happens in so many ways, every day, through the inspiring efforts of doctors, nurses, scientists, patients, families, community leaders and countless others.


zandstra.jpgCancer invaded my life as a new graduate nurse. I vividly remember the doctor coming out of the operating room and speaking those three haunting words, "we found cancer."

My 57-year-young mother endured surgery, chemotherapy and radiation treatments that left her weak, nauseated and in constant pain. In eight short months, she was gone. I felt helpless.
 
The next year, 1979, I traveled from California to Houston and found MD Anderson Hospital and Tumor Institute. I came with a thirst for knowledge and a need to serve.


I joined a nursing unit specializing in the gynecologic cancers that had claimed my mother's life. I was excited to be joining a top cancer center, yet fearful of what I might find.

Would I be up for this challenge? Would I be surrounded by sorrow and suffering? Would all my patients die? With all this in mind, I committed to stay two years.

Making Cancer History® has been a journey I have now traveled for more than 30 years.  Why? I found that each day, I could make a difference. I found a place of hope, inspiration, innovation and discovery.

I have had the opportunity to be on the cutting edge of discovery -- new surgical techniques that would preserve a woman's fertility, novel cancer treatments, new medications to manage pain and nausea, and to improve the quality of life.

cancerstrikethru.jpgEach day and each year, those we have the honor to care for contribute to our mission of eliminating cancer.

Making Cancer History begins with hope -- hope to end suffering from the effects of cancer and its treatment. It's measured not only by the quantity of lives saved, but also by the quality of life experienced by the cancer survivor.

It's also measured by the tireless work of outstanding scientists and clinicians who are learning more about cancer every day and are developing improved methods to treat the disease.

 

By Laura Nathan-Garner, Staff Writer

leadtanningimage.jpgWith temperatures heating up, it's almost time to break out the bathing suits and shorts. That might seem like a good reason to visit a tanning salon -- you know, to bronze your skin before you bare it.

But spending time on a tanning bed can harm you. Last summer, the World Health Organization classified tanning beds in its highest cancer risk category -- "carcinogenic to humans." So those ultraviolet (UV) rays and UVB rays that darken your skin as you lie on the tanning bed can cause cancer.

Tanning increases your skin cancer risk no matter how old you are. But if you're under 30 -- or know a tanning bed user who is -- beware:  Tanning beds increase skin cancer risk by a whopping  75% for users under 30!

Here's more bad news for anyone flirting with visiting the tanning salon: Indoor tanning appears to be an awfully tough habit to break. A new study in the Archives of Dermatology found that more than 30% of college-aged tanning bed users became addicted to tanning. And 78% of the study's most frequent tanners tried to cut back on tanning but couldn't change their ways.

This is why MD Anderson discourages any use of tanning beds. The health price tag for that bronzed look is just too high.

If you really want to look a little darker before you hit the beach, try one of the many safe self-tanning products that will bronze your skin without increasing your risk of skin cancer. Not sure where to start? Check out our suggestions on how to get a healthy glow.

Have you tried self-tanners? If so, what types work best for you? Spray-on or lotions?

MD Anderson New logo credit - F Carter SmithThere's no gray area when it comes to MD Anderson's mission. For almost 70 years, it's been all about eliminating cancer in Texas, the nation and the world.

It's a mission that's easily understood by the thousands of employees and volunteers who roll up their sleeves to work here each day, and by nearly 800,000 patients who have placed their trust in our hands since 1944.

Now, for only the fourth time in the institution's history, we're updating our logo.

The new logo integrates MD Anderson's distinctive tagline, Making Cancer History®, and the long-running cancer strike-through campaign, in which survivors tell their cancer stories and draw a red line through their cancer type to mark their triumph over the disease.

The intent of the mark? It's to make clear to all those who touch MD Anderson the commitment to the mission and the optimism of being on the cusp of major advances toward reaching it.

"Our dream is that five years from now when people anywhere see a red strike through cancer, they'll immediately associate it with MD Anderson and Making Cancer History," says John Mendelsohn, M.D., president of MD Anderson.

"We want to be the first choice for patients and their families, for talented faculty and staff, for donors and volunteers whose support is essential, and for students and trainees aspiring to be future leaders. With this new mark, we've told the world where we stand in the effort to end cancer, so that they can come and stand with us."



Learn more about the history of the MD Anderson Logo: Making Cancer History: The Evolution of a Powerful Idea

Read the News Release: New MD Anderson Logo Challenges Employees, Public to Aspire to a World Without Cancer


By: Dana Lee, Proton Therapy Center Staff

On May 4, 2006, MD Anderson began treating patients with one of the most advanced and innovative technologies available: proton therapy. At that time, MD Anderson Proton Therapy Center was one of only three centers in the nation and the first of its kind integrated within a comprehensive cancer hospital - giving patients the benefit of a powerful technology with fewer side effects, all delivered by world-renowned cancer specialists.

Today, the center remains one of only seven proton therapy centers nationally - and still the only at the top-ranked cancer center in the nation. Our medical experts are harnessing the power of protons to treat even more types of cancer, including cancers of the prostate, lung, liver, esophagus and brain, as well as lymphomas, sarcomas and pediatric cancers.

Watch as Dr. Andrew K. Lee, Dr. James D. Cox and nurse Carolyn Allsen take a look back at the past four years and discuss how the center is currently helping even more patients triumph over cancer through treatment with proton therapy. 

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